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首页> 外文期刊>BMC Pregnancy and Childbirth >Maternal obesity classes, preterm and post-term birth: a retrospective analysis of 479,864 births in England
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Maternal obesity classes, preterm and post-term birth: a retrospective analysis of 479,864 births in England

机译：母亲肥胖课程，早产和后期出生：英格兰479,864个出生的回顾性分析

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BACKGROUND:Preterm (?37?weeks gestation) and post-term birth (≥42?weeks gestation) are associated with increased morbidity and mortality for mother and infant. Obesity (body mass index (BMI) ≥30?kg/m2) is increasing in women of reproductive age. Maternal obesity has been associated with adverse pregnancy outcomes including preterm and post-term birth. However, the effect sizes vary according to the subgroups of both maternal BMI and gestational age considered. The aim of this retrospective analysis was to determine the association between maternal obesity classes and gestational age at delivery.METHODS:A secondary data analysis of 13 maternity units in England with information on 479,864 singleton live births between 1990 and 2007. BMI categories were: underweight (?18.5?kg/m2), recommended weight (18.5-24.9?kg/m2), overweight (25.0-29.9?kg/m2) and obesity classes I (30.0-34.9?kg/m2), II (35.0-39.9?kg/m2), IIIa (40-49.9?kg/m2) and IIIb (≥50?kg/m2). Gestational age at delivery categories were: Gestational age at delivery (weeks): extreme preterm (20-27), very preterm (28-31), moderately preterm (32-36), early term (37, 38), full term (39-40), late term (41) and post-term (≥42). The adjusted odds of births in each gestational age category (compared to full-term birth), according to maternal BMI categories were estimated using multinomial logistic regression. Missing data were estimated using multiple imputation with chained equations.RESULTS:There was a J-shaped association between the absolute risk of extreme, very and moderate preterm birth and BMI category, with the greatest effect size for extreme preterm. The absolute risk of post-term birth increased monotonically as BMI category increased. The largest effect sizes were observed for class IIIb obesity and extreme preterm birth (adjusted OR 2.80, 95% CI 1.31-5.98).CONCLUSION:Women with class IIIb obesity have the greatest risks for inadequate gestational age. Combining obesity classes does not accurately represent risks for many women as it overestimates the risk of all preterm and post-term categories for women with class I obesity, and underestimates the risk for women in all other obesity classes.
机译：背景：早产（<？37？妊娠）和后期出生（≥42？周妊娠）与母亲和婴儿的发病率和死亡率增加有关。肥胖症（体重指数（BMI）≥30？kg / m2）在生殖年龄的女性中越来越多。母亲肥胖与不良妊娠结果有关，包括早产和后期出生。然而，效果大小根据母体BMI和考虑的孕期年龄的亚组而变化。该回顾性分析的目的是确定产妇肥胖课程和胎儿之间的关联。方法：1990年至2007年间，英格兰13个产妇单位的次要数据分析与479,864名单身产物。BMI类别是：体重不足（<？18.5？kg / m2），推荐重量（18.5-24.9？kg / m2），超重（25.0-29.9？kg / m2）和肥胖课程I（30.0-34.9？kg / m2），ii（35.0- 39.9？kg / m 2），iiia（40-49.9？kg / m 2）和iiib（≥50Ωkg / m2）。递送类别的孕龄是：递送时的孕龄（周）：极端早产（20-27），非常预料（28-31），适度早产（32-36），早期（37,38），全文（ 39-40），晚期（41）和后期（≥42）。根据母体BMI类别，每个胎儿年龄类别（与全初期出生相比）的调整后的出生的几率估计使用多项式物流回归。使用链式方程的多个归纳估计缺失数据。结果：极端，非常适中的出生和BMI类别的绝对风险与BMI类别之间存在J形关联，具有极端早产的最大效果大小。随着BMI类别的增加，术语出生的绝对风险将单调增加。对于IIIB级肥胖和极端早产（调整或2.80,95％CI 1.31-5.98），观察到最大的效果大小。结论：IIIB类肥胖的女性对孕龄不足的风险最大。结合肥胖课程不准确代表许多女性的风险，因为它超越了患有I类肥胖的妇女所有早产和妇女的风险，并低估了所有其他肥胖课程的妇女的风险。

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